Intended for healthcare professionals

Rapid response to:

Head To Head Coronavirus Transmission

Should masks be worn outdoors?

BMJ 2021; 373 doi: (Published 28 April 2021) Cite this as: BMJ 2021;373:n1036

Linked Feature

What do we know about airborne transmission of SARS-CoV-2?

Linked Commentary

Why I wear a mask indoors and out

Read our latest coverage of the coronavirus pandemic

Rapid Response:

Voluntary outdoor mask-wearing can have incidental benefits in cities

Dear Editor

The evidence for mandatory mask-wearing in outdoor settings to reduce transmission of SARS-CoV-2 does not meet the threshold for public health intervention either at an individual or community level.[1]. They may be even unforeseen harms particularly in wide open countryside with plenty of fresh air.[2].

Law enforcement agencies may also not welcome mask-wearing in streets and parks as it could hamper identification of criminals on security camera (CCTV) images.

On the other hand, voluntary outdoor mask-wearing may have other incidental benefits. An immediate benefit would be protection from the air pollution that is choking our cities.[3]

COVID-19 pandemic has accelerated the erosion of privacy in our society.[4] It is a matter of time before software companies prime the population to accept facial recognition in everyday life. Masks may provide some degree of privacy against virtual stalking at street level.[5]

1 Javid B, Bassler D, Bryant MB, et al. Should masks be worn outdoors? BMJ 2021;373:n1036. doi:10.1136/bmj.n1036
2 Bonell C, Jamal F, Melendez-Torres GJ, et al. ‘Dark logic’: theorising the harmful consequences of public health interventions. J Epidemiol Community Health 2015;69:95–8. doi:10.1136/jech-2014-204671
3 Soeroso NN, Intan TK, Ichwan M, et al. Four-type of Masks and its Effectiveness Based on Reduced Level of Expiratory Carbon-monoxide. Med Arch 2020;74:342–5. doi:10.5455/medarh.2020.74.342-345
4 Krass M, Henderson P, Mello MM, et al. How US law will evaluate artificial intelligence for covid-19. BMJ 2021;372:n234. doi:10.1136/bmj.n234
5 Editorial. Facial-recognition research needs an ethical reckoning. Nature 2020;587:330. doi:10.1038/d41586-020-03256-7

Competing interests: No competing interests

02 May 2021
Santhanam Sundar
Consultant Oncologist
Nottingham University Hospitals NHS Trust